Vaginismus is a very painful and distressing medical condition where the muscles of the
vagina tighten or tense or contract in anticipation of pain. It makes penetrative sex very painful
and often impossible. Patients describe a burning sensation and often cannot use tampons
or have any kind of gynaecological examination or investigation such as a smear test. It's
important to remember that this is something that's happening automatically in the muscles
of your vagina. It is something you have no control over. It is a muscle spasm, but because
it's such a sensitive subject, patients find it hard to talk to anyone about it. Vaginismus
can cause so much distress and upset. It can cause relationship breakdown, it can make
it very difficult to have children, and patients often feel very much alone and isolated and
feel as if they're the only one with this condition which is not the case.
There is often no explanation why vaginismus has occurred. There may be some fear or anxiety
around penetrative sex. There may have been an experience that was traumatic or painful
in the past and this can cause primary vaginismus. Less commonly, patients have no difficulties
at all with penetrative sex and then develop a medical condition such as an infection like
thrush and then have an experience of pain which then results in vaginismus. And that
is secondary vaginismus.
The good news is that vaginismus is a treatable medical condition. And the treatment depends
on the cause and needs to be tailored according to the patient's needs. It's important to
manage feelings of fear and anxiety around penetrative sex. And sometimes treatment can
be focused on identifying, understanding, and changing those negative perceptions about
body image and penetrative sex. Relaxation techniques and mindfulness techniques can
help with this. Sometimes, though, treatment is focused on retraining those muscles that
are held in tension and this can be done in a variety of ways. Part of it is pelvic floor
exercises. So, the pelvis is the part of the body that contains the vagina, the uterus,
the bowel, and the bladder. And the floor of the pelvis is a sling of muscle. And learning
pelvic floor exercises or Kegels exercises can help with vaginismus. Sometimes the vaginal
muscles themselves need to be targeted. And this can be done very effectively using graduated
vaginal trainers.
It's difficult to estimate how common vaginismus is, because so many women don't seek medical
treatment for it and it is hidden because patients find it quite embarrassing or sensitive
to talk to even a health professional about. But estimates vary. But it is thought about
27,000 women in the UK have vaginismus. Certainly 10 to 15 percent of all women at some point
in their life experience pain during penetrative sex.
Vaginismus is a treatable medical condition, so absolutely, yes, you can have pain free
sex. A specialist in psychosexual medicine will work with you to develop a programme
that will meet your needs and is likely to be successful. I think the hardest step is
taking that first step and asking for help.